The veins you see on your skin are reflections of your vascular health deep to each area they are located. Similar to an iceberg, there is much more going on below the surface. Many of the veins we see superficially on our skin we were not born with. That is these veins have developed because of a response to pressures exerted on the tissues from below. Ultimately, obstruction of flow leads to the body developing alternative pathways for blood to travel. Due to this pressure throughout our lives we develop arteries and veins, this natural process allows for the body to heal tissues and redirect blood flow around traumatized / scarred tissue.
Methods for fixing veins and closure center around basic principles. Many of these treatment options employ the use of mechanical or chemical effects. These repairs are done locally at sites of accessing veins or distally (endovascularly).
Patient’s request regularly to have their veins injected, commonly referred to as sclerotherapy. Many have sites that have required multiple injections. Only to have the veins recur over several months. Usually the root cause, pressure, has not been addressed. Therefore, to be most efficient the root cause of venous disease should be elicited. There-by only by discovering this first can we prevent recurrence. Fundamentally, by eliminating the venous hypertension this improves the odds of preventing recurrent disease.
Venous insufficiency found involving larger veins of the supporting tissue usually needs to be addressed. Treating the Great Saphenous Vein and Small Saphenous Vein of the legs can have a significant effect on painful superficial veins. With these larger veins closed, the pressure in the supporting tissue reduces and the reflection of this superficially, the veins, usually follows suit.
Visible veins can be closed with simple suture closure, or laser, or injections. But what of the veins that are larger/deeper/closer to the root source of pressure? For closure options from within the vein – endovascularly, we travel along the course of veins and effect a change under direct observation, usually ultrasound. Closure utilizing heat or chemical agents. Each have their advantages and disadvantages. Basically, closures are accomplished with minimal anesthesia, in the office setting, with return to normal function in 24-48 hours, and with minimal to no pain (0-2/10 pain). Therefore, over the next few days to weeks patients have varying improvements of symptoms including resolution of open sores, leg pain, buttock pain, low back pain and resolution of restless leg syndrome.
Many people wonder how the symptoms of buttock and back pain can be helped with closure of the Great Saphenous Vein. The Psoas muscle brings your thigh up towards your belly and runs directly under the course of this vein. Therefore, with treatment, inflammation and edema resolve allowing the muscle to heal and stop chronically spasming leading to improved symptoms of buttock and back pain. Patients are astounded when the pain that they always thought was arthritis get better with their treatments.
With the above treatment strategies, we can organize and plan treatment for many cases of venous hypertension. Resolution of the hypertension ultimately helps with superficial symptoms. This indirectly helps prevent venous disease recurrence.
An ounce of prevention is worth a pound of cure – Benjamin Franklin.
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