Veins 101

In the legs there are three groups of veins. There is the deep venous system located within the musculature, the superficial venous system and the perforator system, which connects the superficial to the deep system. Problems can occur in one or a combination of all three systems.

Lower extremity veins are responsible for carrying blood back toward the heart. They have one-way valves which help prevent blood from refluxing back down the leg. Varicose veins result when the normal venous system in the lower extremity becomes dysfunctional. Once the venous valves become incompetent, the vein experiences a back flow of blood along with an increase in hydrostatic pressure. This causes the superficial veins to dilate, bulge and become tortuous. Other factors may also contribute to the development of varicose veins, such as hereditary factors, hormonal changes (especially during pregnancy),and occupational risk, such as prolonged standing.

Over 50 million people in the US are affected by varicose veins.Although women are affected more often, varicose veins also occur frequently in men.

What are Varicose Veins?

Varicose veins are abnormal veins that are no longer functioning appropriately. They may present as bulging, rope-like tortuous veins or small thread-like veins in the lower extremities. They are often associated with discomfort such as throbbing, aching, burning and leg
heaviness, as well as lower extremity edema (swelling).

What are Spider Veins?

Spider veins are small branching veins on the legs. They are believed to arise secondary to hormonal changes, particularly estrogen and progesterone. Because of this, they are much more prevalent in women. Spider veins are usually asymptomatic; however they are often associated with underlying larger feeder veins called reticular veins which may be symptomatic. These veins are often present although not always visible. When present, these feeder veins must be treated in order for the spider veins to respond to therapy.

What is chronic venous insufficiency?

Chronic venous insufficiency (CVI) is often considered the end stage of venous disease. Individuals with this condition often complain of leg edema, difficulty walking and sometimes recurrent or persistent lower extremity ulcers. This condition usually signals that these patients have profound venous dysfunction which affects both the superficial and deep venous system of the lower extremity. Thirty per cent of patients with CVI may also have a history of deep venous thrombosis. In these patients the one-way valves of the lower extremity veins have become extremely dysfunctional. As a result, blood in the lower extremity refluxes back down the legs resulting in a substantial increase in hydrostatic pressure in the lower extremity venous system. This may lead to leg edema, leg heaviness, and even tissue breakdown (ulcers).

What treatment options are available?

Due to the complexity of venous disease, there is no single therapy that is universally efficacious. At Collom and Carney Vascular Associates, we offer the full gamut of treatment modalities, which includes sclerotherapy, subfascial endoscopic perforator surgery (SEPS), venous laser ablation, and mini- phlebectomy. After a comprehensive evaluation, including a detailed history, physical exam and testing (venous sonography), the appropriate intervention or combination of interventions is chosen for the patient’s particular venous problem. This results in the most effective treatment, while also minimizing complications and the recurrence of varicose veins.

If you are interested in being evaluated for treatment for your varicose
veins, please call Collom and Carney Vascular Associates

903-614-3007