Venous disorders include chronic and acute problems.. They cover a wide range of symptoms from the most serious blood clots that threaten our very lives to non-threatening cosmetic blemishes found in the majority of the population. Chronic venous disorders are very frequent; they affect at least 20% of the entire adult population and over 50% of females over 60 years of age. Acute blood clots occur in 2 million Americans each year
Chronic Venous Disorders:
The enormous advances in diagnosis and treatment of the past few years have made the management of vein problems precise and patient-friendly. The wonders of ultrasound-painless imaging of the veins, non-invasive, affordable, accurate-make it possible to actually see the veins under the skin and test their function just by placing jelly and a light probe connected to a computer on the skin. The information is precise and it has become the major source of venous diagnosis in the lower extremity. In addition, advances in minimally-invasive endovascular catheter treatment methods and innovations in special techniques of injection procedures allow effective treatment of 9 out of 10 vein problems. This is done in the office setting with minimal discomfort and almost zero loss of time from normal activity.
In the management of venous disorders the oldest form of treatment is to provide support to the leg’s tissues by bandaging, or by use of compression stockings. This remains an extremely important basic tool for the management of both acute and chronic vein problems because it reverses swelling in the legs and is more effective than other methods, including use of diuretic medications. Expertise in bandaging and prescription of support methods is an important part of successful management of chronic venous and lymphatic disease at KVC.In the spectrum of chronic venous disease spider veins are the least serious and the most frequent problem. They are dilated veins that are actually in the skin and are distinct from varicose viens that are under the skin. They cause mainly cosmetic discomfort and do not necessaruily lead to progressive changes in the deeper veins of the legs.
Varicose veins are much more serious since they frequently cause persistent discomfort and swelling and produce a measurable effect on the individual’s quality of life. Varicose veins do not heal without treatment and they often progress to more advanced problems in the legs with passage of time.
The advanced complications of skin changes from neglected varicose veins can result in discoloration, thickening, and non-healing ulcers (sores) in the skin of the lower legs. These changes occur in an increasing percentage of cases of long standing varicose veins with aging of the individual, especially in the later (Medicare) years. These advanced changes are thought to be largely preventable by appropriate treatment of the abnormal veins earlier in life.
Treatment is individualized in the Kistner Vein Clinic to the simplest effective method appropriate to the diagnosed problem. These treatments can be done with near immediate return to customary activity for most cases.
Acute Venous Disorders:
Acute vein disease consists mainly of blood clots (phlebitis) and their complications. A blood clot in the leg should be suspected when there is swelling or pain in one leg that does not have an obvious cause, such as an injury. Such an occurrence is best investigated with an ultrasound examination, called a ‘duplex scan’. These are painless and affordable tests that are widely available in hospitals and emergency rooms and specialty offices.
The emphasis should be on making the diagnosis early (within 3-5 days) because immediate effective medication can stop the clotting process. This will prevent both short and long term complications from the clot. Untreated blood clots in the deep veins of the leg often travel to the lungs where they are a threat to life in the short term, and produce lifelong damage to the leg veins that causes swelling and disability in the long term.
Treatment of blood clots with newer anticoagulant medications can be done in the majority of cases on an outpatient basis. Effective treatment requires careful follow up to confirm the clotting process has been stopped to prevent new clots from forming and to prevent serious complications.