Venous disease – beyond varicose veins

May 24, 2012 By Jennifer McCallister, M.D.

Most people are familiar with varicose veins and spider veins , but they are just two forms of venous disease.

While spider veins are often just a cosmetic concern, there are more serious forms of venous disease that, left untreated, can cause a variety of health problems.

To understand venous disease, you need to understand vein function. Arteries carry oxygen-rich blood from the heart to the rest of the body. Veins carry the oxygen-depleted blood back to the heart. Muscle contractions help move the blood forward through the veins. When muscles relax, valves within the veins help prevent backwards blood flow.

Venous disease occurs when valves malfunction, causing blood to leak backwards and pool in the vein. Vein weakness or damage is also common with venous disease, which most often occurs in the legs. Among the more prevalent venous diseases characterized by valve malfunction and/or vein damage are:

• Varicose veins: Pooling blood causes veins to bulge and twist. In many cases varicose veins don't produce discomfort, but they can cause pain, swelling, burning or other symptoms.
• Phlebitis (also called thrombophlebitis): A blood clot causes vein inflammation, which can produce pain and swelling. Superficial thrombophlebitis occurs in veins close to the skin surface. Deep vein thrombosis occurs in deeper veins, and can cause potentially life-threatening problems if the clot breaks loose and travels to the heart, lungs, brain or other areas.
• Chronic venous insufficiency (CVI) is caused by excessive blood pressure in the veins. Varicose veins, deep vein thrombosis and other conditions can lead to CVI. Over time, more blood pools in the veins and damage is exacerbated. CVI symptoms include leg swelling, achiness, heaviness, skin discoloration and ulcers.
• Venous stasis ulcers. Over time, pooled blood causes skin pressure and obstructs the flow of fresh, oxygenated blood. The patient may develop ulcers that do not heal or keep returning. Venous stasis ulcers are usually found just above the inside of the ankle. A wound care specialist may be needed to treat ulcers.
• Venous malformations can be hereditary or acquired. Most are slow-growing and do not cause problems, but some may produce symptoms, depending on size and location.
There are a variety of treatments for venous disease. These include compression stockings that are worn to help push blood through the veins. Minimally invasive treatments may include anticoagulant medications, use of catheters inserted into the vein to deliver treatment; laser therapy; sclerotherapy (using a salt solution); and surgery. If you have venous disease, see your doctor, who can help determine the best treatment.

Jennifer McCallister, M.D., is a surgeon and medical director of the Wound Care Center at The Hospital of Central Connecticut. For referrals to HOCC physicians, please contact our free Need-A-Physician referral service by phone at 800.321.6244.